84214C - McCarty, Joshua

&0OW"&FICAMA ❑ DREDGE & FILL `84214 A B C D
GENERAL PERMIT Previous perm``
Date previous permit issued
-❑ New [:]Modification []Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
�I
I SA NCAC ❑Rules attached. I/j I General Permit Rules available at the following link: www degnc.yov/CAMArules
Applicant Name f> S,I i I ('I / s/ Authorized Agent
Address J� U I a f) ( i'or ) ( Project Location (County):
City, ' /L� State Aj((. ZIP Street Address/State Road/Lot#(s)
`i Phone#(%_) 7 f
Email Subdivision
City - ZIPS_
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body F'. •%O CSC n an/unk)
AEC(ss)): ❑❑ OEA ❑IHA Uw ❑$PIMA ❑PWS Closest Maj. Wtr. Body
ORW:yes/rlo PNA: yes/no
Type o{;Project/Activity n"' ! / _fi l (
(Scale``?
Access Length T
Pier(dock)length
Fixed Platforms) 7�
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1
i
—
—
—
—
i
m"
Floating Platform(s) Z-
Finger pier(s)
Total Platform area
Groinlength/#�
Bulkhead/ Riprap length—
Avgdistanceoffshore
Breakwater/Sill
Max distance/length_—
Basin, channel
Cubic yards
Boat ramp /
Boathouse/ Boatlift
Beach Bulldozing
Other
�—
-----
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—
SAV observed: yes no
Moratorium: n/a yes no Site Photos: yes no
Riparian Waiver Attached: yes no
------1
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A building permit/zoning permit may be required by: I�
Agent pf Appbh[ PRINTED Name
Signature **Plea e/ fead coinplj ce statement on back of permit" (/
l�lT �i/•yL���
Application Fee(s) Check #/Money Order
Permit Officer's PRINTED Name
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial) , 'r ,F' ' _
Signat e �
�% r
IssuingOate,f Expiration Date

❑DREDGE & FILL . N9 84214 A B c D
Previous permit
3 GENERAL PERMIT Date previous permit issued
❑New ❑Modification El Complete Reissue ❑Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
�1
15A NCAC ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
Address
City
Phone#(_)_
Email
'f Authorized Agent
Project Location (County):
State ZIP Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body - (nattman/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Won. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale:: )
...........
Access Length
Pier (dock) length
Fixed Platform(s)
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■
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::ESE
:
N:Floating
:n
Platforms) X
Groin length/#
otal Platform ..Avg
Bulkhead/ Rprap length
Breakwater/Silln■■�■
distance/ length
Basin, channel
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A building permit/zoning permit may be required by: I rr_.
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECTAND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signa re "Please read compliance statement on back of permit" Signat re
Application Feels) Check q/Money Order Issuing Date % Expiration Date

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